Thursday, February 10, 2011

Decisions, Decisions

So my plan for the summer was to head home after exams (June 12th). Study like crazy for the USMLE for a month, write it mid July, take the last two weeks of July off, return to Ireland to start placements Aug 1st.

Life has offered up a bit of a curve ball and I am unsure as to what I should do.

I have been given the chance to be involved in a very cool clinical trial here in Ireland during the summer break (where I'll actually get to have some hands-on contact with patients). Problem is, the project will be full time for most of my holiday.

Everyone is always droning on about research and how important it is to have some papers on your CV, especially if I want to specialize or study in the US (I'd like to do both). So I am definitely keen on getting started on a project.

Flip-side is, when will I write the USMLE then? Remembering that our curriculum isn't based on preparing us for the exam, we have a MOUNTAIN of extra-learning to do on material that isn't part of my program. Yes, there is a long Christmas break, I could potentially study for it then, and write in January. But if I do my surgery rotation in the fall it'll leave me very little time to do any continous prep: it'll be one giant cram-fest over Christmas. Yeah, the Christmas break that I was planning to do nothing but drink egg nog and skate on the canal (not necessarily in that order).

Scales: USMLE vs. Research

Thoughts?

(Keep in mind that I am no pro-star when it comes to GIANT EVIL EXAMS OF DOOM.)

See the problem is, none of our faculty are Canadians who have studied in Ireland, written the USMLE, done research, organized international electives, or gone through residency applications for returning to North America. This means there is no one here that I can go to and say, "based on your experiences and your understanding of all these processes, what is your advice?"

We are left a little in the dark here in terms of guidance for our future careers.

One the student RNs that I follow - from Alberta, yet!- (http://undergradrn.blogspot.com/2010/12/ten-year-rule.html) has a very wise decision making tool - "The 10 year rule". When she is head to head with a decision....she simply looks at it in terms of where she wants to be in 10 years.....

As someone involved in interviewing and selecting candidates for a US residency program: USMLE. Many programs use the step scores to create the "consider" and "reject" piles before going through the "consider" pile to decide who to offer interviews to. Invest first in getting into the consider pile, invest second on getting the interview offer.

USMLE, definitely. After loads of lunch talks from residency directors, Step 1 (and to a lesser degree, 2) scores are literally the first thing they look at - and sort of a cutoff for interview offers, too.

You have your whole life to do research. Study. or come visit me, and bring the eggnog. I'll put you as second author on my HIV screening study if you'll proofread and help with the qualitative coding when i'm finished.xoxoxo

actually the new school of thought is 20 weeks prep for the USMLE. doctorsintraining.com as for the research people do care that you are a first author but i would do research when you arent going to take step. id say a month is not hardly any time to prepare for step especially if youre school hasnt prepared you for it. good luck

Chief, is that 20 weeks of dedicated study without med school classes in the spaces between? In the old days we spent a month or so after 2nd year intensively studying in addition to prior review +/- a prep course. My PBL director loved to cite that a student couldn't maintain intensive study longer than 6 weeks. Have times really changed this much or is the 20 week program just mixed in with the standard med school course load?

I agree that 4 weeks of study without underlying foundational preparation is insufficient. I always felt I spent the first 2 academic years of med school studying for boards in addition to my dedicated study. My PBL program encouraged all of us to simply read and learn as much as possible in the context of our cases rather than study/pander to an exam. Each of us did very well on Step 1.

Thanks all for your thoughts and input, very helpful to hear from people across the spectrum of HCW and the process (students, residents, specialists, nurses, selections staff,..etc.)

Ok so that was a RESOUNDING:

"USMLE"!

I emailed the project leader and told him my story to see what his thoughts were. Likely going to have to pass it up. :(

@Grump/OMDG: Noted, and good point OMDG.

@CC: Well, the 10 year rule is that I just hope to be practicing in North America by that point! =) And yes, I'd prefer skating on the Canal and hanging in BC over anything else.

@Sarah: Good to know, and as someone who up to this point seems to have a propensity for ending up in the 'reject' pile, I want to do everything I can to make myself attractive to future residency programs.

@AB :) Will keep you posted!

@MD2B: Thanks, good to know.

@Keet: I am holding you to that! :)

@PGYX: I have never heard that the Canadian exams are harder than the USMLE. I have heard they are more clinically oriented (which for me is good). A friend of mine who is an ER doc in Canada told me I could pass them now if I wrote them. I plan to write both and apply to both Canada and the US. I just think that I have a better shot in the US (and Tobie *loves* the States and is willing to live there with me long-term if need be).

Yeah, I am doing some continuous review now but most of my classmates that have written say 3-4 weeks of concentrated study was enough, after that they were sick of it and ready to write.

@Chief: I am assuming that you mean 20 weeks of part-time review as most medical schools don't leave 5 months off for students to study for the exam (at least in Canada or Ireland). I am currently studying for it, and taking a weekly course--but my push at the end of full time studies is only going to be 4 weeks. Tops.

Thanks for the link.

RH--Hahah, thanks! Yes, I've had that book since last year. I go through the First Aid stuff which relates to our PBL cases and hope that I am covering what I need for both.

Honey, I am 62 years old and have not been to medical school, but I have learned some things about life. take the Christmas vacation where you do nothing but drink egg nog! Give yourself a break. Be kind to yourself (at least as much as you can right now. You are doing a difficult and admirable thing, but give yourself permission to live a little. Life is too short to be a grind all the time.

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"I cannot rest from travel; I will drink Life to the Lees. All times I have enjoyed Greatly, have suffered greatly, both with those That loved me, and alone; on shore, and when Through scudding drifts the rainy Hyades Vext the dim sea. I am become a name; For always roaming with a hungry heart..." Lord Tennyson